Deciphering unilateral congenital facial palsy in neonates: A case series and literature review

Abstract

Unilateral facial palsy in neonatal period either occurs in isolation or in association of a syndrome. We report three neonates, two boys and one girl, who presented with unilateral facial palsy at birth. Clinical assessment was performed by a neonatologist, ear-nose-throat (ENT) surgeon, an ophthalmologist and a physiotherapist. Magnetic resonance imaging (MRI) of the brain in two neonates and additional computerized tomography (CT) of the temporal bone in one patient was done to exclude developmental anomalies of the facial nerve. Imaging revealed an underlying underdevelopment etiology with absence of cochlea in one neonate. These findings point towards the importance of imaging and systematic diagnostic work-up. This article describes a multidisciplinary approach toward unilateral, isolated congenital facial palsy along with a literature review. Role of physiotherapy, auditory rehabilitation, and other medical and surgical options have also been discussed.